June 23, 2017

Why Would Your Insurance Company Demand an EUO (Examination Under Oath) ?

Your insurance company may demand an EUO (Examination Under Oath) for a number of reasons such as looking for additional information, investigating potential fraud or as an intimidation tactic to potentially scare an insured.

A recent article on claimsjournal.com had the headline “How to Effectively Use Examinations Under Oath.”  This article was produced to help educate adjusters when to use this “tool” and how to use it during the claims process.  If more and more adjusters move toward using this “tool”, it is an indication of how claims are to be handled in the coming months and years.  The days of taking a an insured’s word at face value a going the way of the dinosaurs.  With this approach, the insurance company appears to be asking an insured to prove their loss, and then question the manner in in which the insured determined that loss.  It would appear that many, many claims are going to wind up in legal action.

One excerpt from the article (link to article below) that jumps out when and how the insurer has to demand an EUO (some states vary slightly, but the process is very similiar).

EUO Demand

“An insurer must provide a demand for an EUO in the form of a written notice in order to schedule one. According to King and Mishall, the letter to the insured should include the following:

  • The name of the insured representative who will be examined.
  • The time and place of the examination – must be reasonable and convenient.
  • A list of documents needed prior to the scheduled examination.
  • The name of the individual who will be conducting the examination.
  • Reservation of rights in order to designate additional individuals.

Mishall said that it’s important to note that an insurer can schedule more than one EUO with an insured. Examinations can be scheduled with various individuals within an insured company who may have specialized knowledge of the insured business, or multiple examinations may focus on different aspects of a claim.

According to Mishall, those who can be present at an examination include the insured, insured’s attorney, and/or insured’s public adjuster; insurer, adjuster and attorney; court reporter or notary.

Unlike during a deposition, while attorneys may be present, they cannot participate in an EUO. Questions asked must be relevant and material to the loss, Mishall said. Reasonable questions include requesting information about an insured’s finances, possible motives for fraud and claims history.

Because the insurance contract is a voluntary one, an insured cannot plead the Fifth Amendment in refusing to comply with a demand for an EUO. “It is grounds for voiding the policy,” Mishall said.

Although an insured must comply to avoid breaching the policy condition, there are some valid excuses for an insured’s refusal to comply, according to the presenters. These include a defective notice of intent to examine, objection to unreasonable time and place, and denial of the insured’s right to have an attorney present. In addition, if an insurer denies coverage prior to the end of the time period to submit a proof of loss, it excuses the insured from complying with the demand.”

Reading this section of the article, we see the insurance company can bring in anyone in their company that is an “expert” in what they are asking you about (maybe a fire investigator) and they can ask anything they want.  You can bring your attorney, but they cannot ask anything or contribute to the answering of questions.  And yes, you have to answer the questions.  You cannot avoid answering any questions or you have violated the insurance contract and the claim will be denied. Imagine the police asking you questions and not being able to have legal advice or pleading the fifth.  This process provides you little protection and lots of risk.

If your claim is being delayed and the adjuster is reminding you or the insurance company’s right to an EUO, you need to start looking for representation that knows this process and how to help protect your position.

For your free claim review, please call us toll free (855) 757 2757.

At American Property Loss Services, Inc. “Your Recovery is Our Success.”

How to Effectively Use Examinations Under Oath. ClaimsJournal.com

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